中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2012年
1期
1-4
,共4页
臂丛%儿童%霍纳综合征
臂叢%兒童%霍納綜閤徵
비총%인동%곽납종합정
Brachial plexus%Child%Horner syndrome
目的 探讨Horner征在产瘫中的诊断意义,寻找单纯C7神经根撕脱导致Horner征的特异性临床体征.方法 对2009年1月至7月在我院接受手术治疗的39例Horner征阳性的产瘫患儿,术前记录患侧Horner征3项临床体征:瞳孔大小,睑裂大小及面部汗腺分泌功能.术中通过直视观察联合神经电生理检查明确患儿神经根损伤程度,并在患儿术后首次随访时再次记录Horner征的各项体征.结果 产瘫患儿平均首次评估Horner征时间为(3.58±0.87)个月.术后平均随访时间为(6.19±1.10)个月.术中证实单纯C7神经根撕脱患儿11例,C8、T1神经根中至少有1根撕脱患儿28例.2组患儿2次瞳孔缩小率和睑裂缩小率比较差异均无统计学意义(P＞0.05).前组患儿在术后6个月时,面部出汗功能恢复优于后组(P＜0.05).结论单纯C7神经根撕脱可导致产瘫患儿出现Horner征.但在3个月龄患儿中已不能辨别其可能存在的特异性临床体征表现.
目的 探討Horner徵在產癱中的診斷意義,尋找單純C7神經根撕脫導緻Horner徵的特異性臨床體徵.方法 對2009年1月至7月在我院接受手術治療的39例Horner徵暘性的產癱患兒,術前記錄患側Horner徵3項臨床體徵:瞳孔大小,瞼裂大小及麵部汗腺分泌功能.術中通過直視觀察聯閤神經電生理檢查明確患兒神經根損傷程度,併在患兒術後首次隨訪時再次記錄Horner徵的各項體徵.結果 產癱患兒平均首次評估Horner徵時間為(3.58±0.87)箇月.術後平均隨訪時間為(6.19±1.10)箇月.術中證實單純C7神經根撕脫患兒11例,C8、T1神經根中至少有1根撕脫患兒28例.2組患兒2次瞳孔縮小率和瞼裂縮小率比較差異均無統計學意義(P＞0.05).前組患兒在術後6箇月時,麵部齣汗功能恢複優于後組(P＜0.05).結論單純C7神經根撕脫可導緻產癱患兒齣現Horner徵.但在3箇月齡患兒中已不能辨彆其可能存在的特異性臨床體徵錶現.
목적 탐토Horner정재산탄중적진단의의,심조단순C7신경근시탈도치Horner정적특이성림상체정.방법 대2009년1월지7월재아원접수수술치료적39례Horner정양성적산탄환인,술전기록환측Horner정3항림상체정:동공대소,검렬대소급면부한선분비공능.술중통과직시관찰연합신경전생리검사명학환인신경근손상정도,병재환인술후수차수방시재차기록Horner정적각항체정.결과 산탄환인평균수차평고Horner정시간위(3.58±0.87)개월.술후평균수방시간위(6.19±1.10)개월.술중증실단순C7신경근시탈환인11례,C8、T1신경근중지소유1근시탈환인28례.2조환인2차동공축소솔화검렬축소솔비교차이균무통계학의의(P＞0.05).전조환인재술후6개월시,면부출한공능회복우우후조(P＜0.05).결론단순C7신경근시탈가도치산탄환인출현Horner정.단재3개월령환인중이불능변별기가능존재적특이성림상체정표현.
Objective To discuss the diagnostic value of concurrent Horner's sign in infants with obstetric brachial plexus palsy and discover the clinical characteristics of Horner's syndrome caused by C7 nerve root avulsion alone.Methods From January 2009 to July 2009,39 infants with OBPP were identified with concurrent Horner' s syndrome.Clinical signs of Homer's syndrome were recorded which include ipsilateral blepharoptosis,pupillary miosis and facial anhidrosis.Lesions of brachial plexus nerve roots were confirmed during the surgery by direct visualization and electrophysiology.After a period of 6-month follow-up,these signs were recorded again.Results The initial age of Horner's sign evaluation of these OBPP patients was(3.58 ±0.87)months.Average postoperative follow-up interval was(6.19 ± 1.10)months.C7 nerve root avulsion alone was confirmed in 11 patients(case group),while the other 28 patients(control group)lind avulsion of at least one root of C8 and T1 nerve roots.There were not significant differences in anisocoria and blepharoptosis between the two groups(P ＞ 0.05).Facial gland secretary function was recovered more rapidly among patients in case group than their counterparts(P ＜ 0.05).Conclusion In newborns with OBPP,Horner' s syndrome can be correlated with C7 nerve root avulsion alone.No unique feature of Horner's syndrome which caused by C7 nerve root avulsion was found among patients of 3 months old.
